أكمل عرض السعر السابق
تكافل الراجحي هي واحدة من الشركات القليلة في المملكة العربية السعودية التي تمتلك الموارد اللازمة لتقديم برامج رعاية صحية متكاملة وفعالة مثل بوليصة التأمين الصحي الموحدة ، والتي تتوافق تمامًا مع متطلبات مجلس الضمان الصحي
بلاتيني
ذهبي
فضي
أساسي
بلاتيني
ذهبي
فضي
أساسي
تكافل الراجحي هي واحدة من أهم الشركات القليلة التي تمتلك الموارد اللازمة لتقديم برنامج رعاية صحّي متكامل وفعّال في المملكة العربية السعودية، والتي تتوافق جميع منتجاتها مع متطلبات مجلس التأمين الصحّي التعاوني.
توفّر لك "وثيقة صاحب العمل الصحيّة الموحّدة" مجموعة ممتازة من خيارات الرعاية الصحيّة. ويُمكنك الاختيار من بين أربع وثائق مختلفة وعالية الجودة، والمتوافقة مع متطلبات مجلس الضمان الصحّي. يمكنك الاستفادة أنت وموظفيك وأفراد أسرتهم من الرعاية الصحيّة الاستثنائية من خلال مجموعة واسعة من مزوّدي الخدمة والمستشفيات، حيث ستحصل على الرعاية التي تناسب احتياجاتك. نقوم بإصدار بطاقات صحيّة شخصيّة لجميع المشتركين المُؤمّن عليهم في الوثيقة لضمان تلقّي الخدمة عند أيٍ من شركائنا من مزودي الخدمة.
أسعار منافسة
تفاصيل الوثيقة
المنافع
استفد من تأميننا الصحي الذي يغطي الحد الأدنى من التغطية والمنافع بحسب مجلس الضمان الصحي وبأسعار منافسة
فوائد | بلاتيني | ذهبي | فضي | أساسي |
|---|---|---|---|---|
| Prior Approval Limits | Prior Approval Limits SR 1000 |
Prior Approval Limits SR 500 |
||
| Room & Board in the appointed medical Network Provider is 100% | Room & Board in the appointed medical Network Provider is 100% Regular Suite |
Room & Board in the appointed medical Network Provider is 100% Single Room |
Room & Board in the appointed medical Network Provider is 100% Shared Room |
|
| Room & Board outside the network of providers (in/out KSA): | Room & Board outside the network of providers (in/out KSA): Per Day SR 1000 |
Room & Board outside the network of providers (in/out KSA): Per Day SR 800 |
Room & Board outside the network of providers (in/out KSA): Per Day SR 600 |
|
| Annual Limit (Sum Insured) Per Person Per Year (PPPY) including sublimits mentioned in the Policy (*Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand). | Annual Limit (Sum Insured) Per Person Per Year (PPPY) including sublimits mentioned in the Policy
(*Small and medium enterprises are supported through Insurance Daman program for expenses exceeding 500 thousand). SR 1,000,000* |
|||
| Reimbursement Benefit: Reimbursement of claims is applied for emergency and non-emergency cases Outside and Inside KSA on Reasonable & Customary basis for the same eligible ART networks. | Reimbursement Benefit: Reimbursement of claims is applied for emergency and non-emergency cases Outside and Inside KSA on Reasonable & Customary basis for the same eligible ART networks. Covered Emergency & Non-Emergency |
Reimbursement Benefit: Reimbursement of claims is applied for emergency and non-emergency cases Outside and Inside KSA on Reasonable & Customary basis for the same eligible ART networks. Covered Emergency |
||
| Territorial Scope: Extended to Worldwide in emergency cases only while on Business trips, Vacation and Holidays for upto 60 days in the aggregate. | Territorial Scope: Extended to Worldwide in emergency cases only while on Business trips, Vacation and Holidays for upto 60 days in the aggregate. KSA |
|||
| Chronic & Pre-existing Conditions up to Policy Limit PPPY | Chronic & Pre-existing Conditions up to Policy Limit PPPY Covered |
|||
| In-Patient Companion (for children below 12 years) Or when the case medically required subject to the treating physician | In-Patient Companion (for children below 12 years) Or when the case medically required subject to the treating physician Covered |
|||
| Pregnancy/Delivery Benefit: (Normal Delivery, Ante Natal Care, Caesarian Section & Abortion) | Pregnancy/Delivery Benefit: (Normal Delivery, Ante Natal Care, Caesarian Section & Abortion) SR 25,000 |
Pregnancy/Delivery Benefit: (Normal Delivery, Ante Natal Care, Caesarian Section & Abortion) SR 20,000 |
Pregnancy/Delivery Benefit: (Normal Delivery, Ante Natal Care, Caesarian Section & Abortion) SR 15,000 |
|
| Delivery complication: | Delivery complication: Covered |
|||
| Pre term newly born babies coverage is up to policy annual limit from day one of the policy | Pre term newly born babies coverage is up to policy annual limit from day one of the policy Covered |
|||
| Co-insurance /Deductible: The Insured/Patient will pay The Percentage mentioned as co-insurance against each and every Outpatient Claim. | ||||
| In-Patient & Emergency Treatments | In-Patient & Emergency Treatments NIL |
|||
| Minimum network of Hospitals and Clinics (MPN) | Minimum network of Hospitals and Clinics (MPN) 20% up to SR 75 |
|||
| Clinics, Medical Centers, Labs, Pharmacies outside minimum network (OCN) | Clinics, Medical Centers, Labs, Pharmacies outside minimum network (OCN) 20% up to SR 100 |
|||
| Hospitals outside minimum network (OHN) | Hospitals outside minimum network (OHN) 20% up to SR 300 |
|||
| Generic, Over-the-counter drugs (OCT) and innovative treatment - with no generic alternative | Generic, Over-the-counter drugs (OCT) and innovative treatment - with no generic alternative 20% up to SR 30 |
|||
| Innovative treatment - with a generic alternative | Innovative treatment - with a generic alternative 50% (No Max Cap) |
|||
| Consultation fees in the appointed Network providers. | Consultation fees in the appointed Network providers. Covered |
|||
| Vaccinations for Children as specified by MOH up to (6) years of age | Vaccinations for Children as specified by MOH up to (6) years of age Covered |
|||
| Dental Benefit 1200 SAR with NIL Deductible for Essential & Preventive Dentistry. 800 SAR with 20% Deductible with No Max Cap for Treatments of Root Canals and Emergencies | Dental Benefit
1200 SAR with NIL Deductible for Essential & Preventive Dentistry.
800 SAR with 20% Deductible with No Max Cap for Treatments of Root Canals and Emergencies SR 3,000 |
Dental Benefit
1200 SAR with NIL Deductible for Essential & Preventive Dentistry.
800 SAR with 20% Deductible with No Max Cap for Treatments of Root Canals and Emergencies SR 2,500 |
Dental Benefit
1200 SAR with NIL Deductible for Essential & Preventive Dentistry.
800 SAR with 20% Deductible with No Max Cap for Treatments of Root Canals and Emergencies SR 2,000 |
|
| Optical: Frames & Medical Lenses up to PPPY (Only for those aged 14 years and less) | Optical: Frames & Medical Lenses up to PPPY
(Only for those aged 14 years and less) SR 1,500 |
Optical: Frames & Medical Lenses up to PPPY
(Only for those aged 14 years and less) SR 1,000 |
Optical: Frames & Medical Lenses up to PPPY
(Only for those aged 14 years and less) SR 400 |
|
| Renal Dialysis | Renal Dialysis SR 180,000 |
|||
| Kidney Transplant | Kidney Transplant SR 250,000 |
|||
| Hearing Aids | Hearing Aids SR 6,000 |
|||
| Ambulance: within the city limits / Borders | Ambulance: within the city limits / Borders Covered |
|||
| Repatriation of bodily remains to Home Country | Repatriation of bodily remains to Home Country SR 10,000 |
|||
| Physiotherapy | Physiotherapy Covered |
|||
| Physician Charges Limits inside the network | ||||
| General Physician | General Physician Covered |
|||
| Specialist I (Registrar ) | Specialist I (Registrar ) Covered |
|||
| Specialist I I(Senior Registrar) | Specialist I I(Senior Registrar) Covered |
|||
| Consultant | Consultant Covered |
|||
| Rare specialties such as the heart and vascular surgery, brain , nerves and subspecialties standards by the Saudi Commission for Health Specialties | Rare specialties such as the heart and vascular surgery, brain , nerves and subspecialties standards by the Saudi Commission for Health Specialties Covered |
|||
| Physician Charges Limits outside the network | ||||
| General Physician | General Physician SR 50 |
|||
| Specialist I (Registrar ) | Specialist I (Registrar ) SR 200 |
|||
| Specialist I I(Senior Registrar) | Specialist I I(Senior Registrar) SR 100 |
|||
| Consultant | Consultant SR 300 |
|||
| Rare specialties such as the heart and vascular surgery, brain , nerves and subspecialties standards by the Saudi Commission for Health Specialties | Rare specialties such as the heart and vascular surgery, brain , nerves and subspecialties standards by the Saudi Commission for Health Specialties SR 500 |
|||
| CS / NVD '' IVF PREGNANCIES" Delivery Limit | CS / NVD '' IVF PREGNANCIES" Delivery Limit Covered |
|||
| Cost of Transplanting Organs " Donor" | Cost of Transplanting Organs " Donor" SR 50,000 |
|||
| Alzheimer's Cases | Alzheimer's Cases SR 15,000 |
|||
| The cost of the national program to reduce disability for newborns to reduce disability | The cost of the national program to reduce disability for newborns to reduce disability SR 100,000 |
|||
| Disability Cases | Disability Cases SR 100,000 |
|||
| Obesity Operation | Obesity Operation SR 15,000 (with 20% Copayment up to Max 1000/SR) |
|||
| Contraception (Hormonal Contraceptives Therapy and Intrauterine Devices) | Contraception (Hormonal Contraceptives Therapy and Intrauterine Devices) SR 1,500 |
|||
| Circumcision for newly born boys | Circumcision for newly born boys SR 500 |
|||
| Ear piercing for newly born girls | Ear piercing for newly born girls SR 300 |
|||
| Table of immunization of the Respiratory syncytial virus (RSV) approved by the Ministry of Health | Table of immunization of the Respiratory syncytial virus (RSV) approved by the Ministry of Health Covered |
|||
| Coverage of the early screening program for hearing impairment and the program of congenital heart defects for all births. | Coverage of the early screening program for hearing impairment and the program of congenital heart defects for all births. Covered |
|||
| Covering the operations of treating obesity through the process of quantifying the stomach only (Sleeve) in the case of BMI 45 (BMI) | Covering the operations of treating obesity through the process of quantifying the stomach only (Sleeve) in the case of BMI 45 (BMI) SR 20,000 |
|||
| Autism Cases | Autism Cases SR 50,000 |
|||
| Milk formula for infants up to 24 months of age, when medically necessary and as per the Internationally recognized indications. | Milk formula for infants up to 24 months of age, when medically necessary and as per the Internationally recognized indications. Covered |
|||
| Cover the costs of psoriasis treatment | Cover the costs of psoriasis treatment Covered |
|||
| Psychological disorders | Psychological disorders SR 50,000 |
|||
| Cover non-acute conditions with limit of (SR 5000) for 4 sessions with medicine | Cover non-acute conditions with limit of (SR 5000) for 4 sessions with medicine SR 15,000 |
|||
| Cost Of Cardiac Valves Failure | Cost Of Cardiac Valves Failure SR 150,000 |
|||
| Coverage of newborns on the mother's card up to a maximum of 30 days from the date of birth until they are added in the policy retroactively from the date of birth. | Coverage of newborns on the mother's card up to a maximum of 30 days from the date of birth until they are added in the policy retroactively from the date of birth. Covered |
|||
| Adult Vaccination as per MOH (including Tdap, PCV13, PPSV23 and influenza vaccine) | Adult Vaccination as per MOH
(including Tdap, PCV13, PPSV23 and influenza vaccine) Covered |
|||
| Sexually Transmitted Diseases (STDs) | Sexually Transmitted Diseases (STDs) Covered |
|||
| Periodic examinations / Screenings | Periodic examinations / Screenings Covered |
|||
| Menopausal and Perimenopausal Health Care | Menopausal and Perimenopausal Health Care Covered |
|||
| Telemedicine | Telemedicine Covered |
|||
اكتشف برنامج سلامتي والتي يأخذك ما وراء الرعاية الصحية التقليدية لرعايتك ورعاية عائلتك.
يمكنك الاستفادة من الخدمات الطبية عن بُعد وإدارة الأمراض المزمنة والخدمات المخبرية واللقاحات في المنزل. يتم تقديم هذه الخدمات من خلال فريق مختص من الأطباء لنوفر لك الخدمة التي تستحقها.
